blood results help

[Joannak]

Hi am currently using novothyral 75mg am wondering if I might need a increase blood drawn last week results below

Thyroid Stimulating Hormone (TSH) 0.637

Free Thyroxine (FT4) 14.00

Free Tri-iodothyronine (FT3) 4.03

[SeasideSusie Remembering]

Joannak

Please add reference ranges that came with these results. Ranges vary from lab to lab so we can't interpret results without the exact ranges that your lab uses. If those results were done with my GP surgery your FT4 would be 70% through range, if they were done by one of our popular private labs used here it would be 20% through range, so you can see how important it is to know the reference range

[Joannak in reply to SeasideSusie]

Hi Susie I used Randox 1150am fully fasted no meds since the day before unfortunately Gp isn’t interested in my results this thyroid went off when I had a full hysterectomy 2017 I use Marion Gluck clinic in London but can’t get an appointment until August with my consultant thankyou for responding

[SeasideSusie Remembering in reply to Joannak]

Need reference ranges please, I am not familiar with Randox.

[Joannak in reply to SeasideSusie]

is this ranges sorry am rubbish at this

Hopeful this has ranges

[SeasideSusie Remembering in reply to Joannak]

Yes, that's right

Do you take any supplements and if you take biotin or any supplement containing biotin (eg B Complex) did you leave it off for 3-7 days before test? Biotin gives false results.

TSH: 0.637 (0.35-5.5)

FT4: 14 (11.9-21.6) = 21.65%

FT3: 4.03 (3.1-6.8) = 25.14%

I believe Novothyral contains 75mcg T4 and 15mcg T3.

Taking a combination thyroid hormone replacement means that the T3 it contains generally lowers (maybe even suppresses) TSH and tends to show a lower FT4 with often a higher FT3.

When taking a combo medication it would be usual to split the dose the day before and take the last part of the dose 8-12 hours before the test. This is because of the T3 it contains. Leaving 24 hours is normal for Levo (T4 only) but as FT3 is the more important result we want that to be as close to what would be the normal circulating amount of hormone and 8-12 hours time gap gives a better picture. So as you've left what's possibly 24 hours or so since last dose and testing your results will show a lower FT3 that if you'd left the advised 8-12 hours.

So if we say your FT3 would be a bit higher than that measured, your results are quite typical of a combo medication but they do show that you are undermedicated. One would expect to see FT3 over half way through range when taking a T3 containing medication.

But an important question is - how do you feel? If you feel fine then change nothing. If you don't feel optimally medicated then consider increasing your dose. Maybe try Novothyral 100 which is 100mcg T4 and 20mcg T3 and see how you feel and what your results are like about 8 weeks after increase.

How are your key nutrients - Vit D, B12, Folate, Ferritin? These all need to be at optimal levels for thyroid hormone to work properly.

With regard to"optimal" levels, please ignore what Randox says about these. They put the whole of the reference range as optimal as we can see from your results image. This is nonsense. With thyroid optimal is where you feel well, which can be different for everyone. With vitamins optimal levels are generally said to be

Vit D: 100-150nmol/L (or 40-60ng/ml)

B12: top of range for serum B12, if Active B12 is tested then 100 plus

Folate: at least half way through range

Ferritin: some experts say the optimal level for thyroid function is 90-110ug/L

[Joannak]

This is amazing information thankyou yes I don’t supplement for 1 week before bloods all my vitamin levels are optimal thankyfully next bloods I will definitely make sure and adjust the timing to ensure am getting the most accurate levels. At the moment am feeling good but I was originally on 100 and am now questioning after all the above info if it should have went to 75 so come august am hoping this will be relooked at thankyou again

[Joannak]

greygoose my previous bloods I felt awful 😩

[greygoose in reply to Joannak]

Well you would feel awful with those low frees. You were very under-medicated.